Provider Demographics
NPI:1134133564
Name:DRS. HARRIS, SIRKIN & KRUGER
Entity Type:Organization
Organization Name:DRS. HARRIS, SIRKIN & KRUGER
Other - Org Name:TRENTON DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-791-6154
Mailing Address - Street 1:4157 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1158
Mailing Address - Country:US
Mailing Address - Phone:513-791-6154
Mailing Address - Fax:513-791-1449
Practice Address - Street 1:4157 HUNT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1158
Practice Address - Country:US
Practice Address - Phone:513-791-6154
Practice Address - Fax:513-791-1449
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH132851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0559917Medicaid